Community-Based Palliative Care Leader Perspectives on Staffing, Recruitment, and Training


Nancy Dudley, Susan Chapman and Joanne Spetz

Apr 2018

This qualitative descriptive study assesses perspectives of US community-based palliative care program leaders on staffing, recruitment, and training. Leaders from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans Administration were recruited to participate.

Three major categories emerged that influence community-based palliative care workforce team composition across settings:

  1. Staffing models and recruitment are influenced by setting and workforce experience.
  2. Training varies by setting.
  3. Demand exceeds the supply of the trained workforce.

Participants described a hybrid approach, mainly used in academic and community settings, that leveraged social work and chaplaincy from home health, hospice, and inpatient departments to create interdisciplinary teams. It was reported that in academic settings, physician-led interdisciplinary teams were more common. Comparatively, participants in community settings reported that teams are more often led by nurse practitioners. Community program leaders expressed the desire to recruit nurses with home health and hospice experience because of their ability to work independently. Training was described as on-the-job more often in community settings. Turnover related to the lack of a properly trained workforce was described as one of the biggest barriers to palliative care development.